Administration of a low dose tiletamine-zolazepam combination to cats

Effects of three immobilizing drug combinations on ventilation, gas exchange and metabolism in free-living African lions (Panthera leo)

Free-living lions (12 per group) were immobilized with tiletamine-zolazepam-medetomidine (TZM), ketamine-medetomidine (KM), or ketamine-butorphanol-medetomidine (KBM). During immobilization, respiratory, blood gas and acid-base variables were monitored for 30 minutes. Respiratory rates were within expected ranges and remained constant throughout the immobilizations. Ventilation increased in lions over the immobilization period from 27.2 ± 9.5 to 35.1 ± 25.4 L/min (TZM), 26.1 ± 14.3 to 28.4 ± 18.4 L/min (KM) and 23.2 ± 10.8 to 26.7 ± 14.2 L/min (KBM). Tidal volume increased over the immobilization period from 1800 ± 710 to 2380 ± 1930 mL/breath (TZM), 1580 ± 470 to 1640 ± 500 mL/breath (KM) and 1600 ± 730 to 1820 ± 880 mL/breath (KBM). Carbon dioxide production was initially lower in KBM (0.4 ± 0.2 L/min) than in TZM (0.5 ± 0.2 L/min) lions but increased over time in all groups. Oxygen consumption was 0.6 ± 0.2 L/min (TZM), 0.5 ± 0.2 L/min (KM) and 0.5 ± 0.2 L/min (KBM) and remained constant throughout the immobilization period. Initially the partial pressure of arterial oxygen was lower in KBM (74.0 ± 7.8 mmHg) than in TZM (78.5 ± 4.7 mmHg) lions, but increased to within expected range in all groups over time. The partial pressure of arterial carbon dioxide was higher throughout the immobilizations in KBM (34.5 ± 4.2 mmHg) than in TZM (32.6 ± 2.2 mmHg) and KM (32.6 ± 3.8 mmHg) lions. Alveolar-arterial gradients were initially elevated, but decreased over time for all groups, although in KM lions it remained elevated (26.9 ± 10.4 mmHg) above the expected normal. Overall, all three drug combinations caused minor respiratory and metabolic side-effects in the immobilized lions. However, initially hypoxaemia occurred as the drug combinations, and possibly the stress induced by the immobilization procedure, hinder alveoli oxygen gas exchange.

Comparison of intratesticular and intramuscular administration of zolazepam-tiletamine combination on sedation, induction, and recovery qualities and vital variables in cats undergoing castration: a prospective, randomized, clinical study

This study was aimed to compare the effects of intratesticular (IT) and intramuscular (IM) administration of the zolazepam-tiletamine (ZT) combination on sedation, induction, and recovery qualities and vital variables in cats undergoing castration. Fourteen clinically client-owned healthy cats were randomly assigned to receive 10 mg/kg ZT by either IT or IM routes. Temperament score, injection reaction score, induction time, intubation time, surgical length, anesthesia time, recovery time, and full recovery time were evaluated. Sedation score, heart rate (HR), respiratory frequency (f_R), peripheral hemoglobin oxygen saturation (SpO₂), mean arterial pressure (MAP), and rectal temperature (RT) variables were assessed at baseline (T0), T5, T10, T15, and T30. Median temperament score and injection reaction score were not different between groups. Induction time was significantly (p = 0.0244) shorter for the IT group (142.6 ± 29.9) than IM (290 ± 48.7 seconds). Length of anesthesia was longer in the IM group (median 290; ranged 120-540 minutes) than the IT group (median 140; ranged 98-180 minutes) (p = 0.0279). Time to standing and time to full recovery were significantly shorter in IT than IM. A recovery quality score did not significantly differ between groups (p = 0.2268). No statistically significant differences were detected between IT and IM administration regarding sedation score, HR, SpO₂, MAP, and RT. The IT administration of 10 mg/kg ZT induces shorter onset of sedation and recovery time than IM administration, thereby it can be suggested for cats undergoing castration. Both administration routes produce effective sedation with limited physiological changes in anesthesia variables.

Feline procedural sedation and analgesia: When, why and how

PRACTICAL RELEVANCE

Procedural sedation and analgesia (PSA) describes the process of depressing a patient's conscious state to perform unpleasant, minimally invasive procedures, and is part of the daily routine in feline medicine. Maintaining cardiopulmonary stability is critical while peforming PSA.

CLINICAL CHALLENGES

Decision-making with respect to drug choice and dosage regimen, taking into consideration the cat's health status, behavior, any concomitant diseases and the need for analgesia, represents an everyday challenge in feline practice. While PSA is commonly perceived to be an uneventful procedure, complications may arise, especially when cats that were meant to be sedated are actually anesthetized.

AIMS

This clinical article reviews key aspects of PSA in cats while exploring the literature and discussing complications and risk factors. Recommendations are given for patient assessment and preparation, clinical monitoring and fasting protocols, and there is discussion of how PSA protocols may change blood results and diagnostic tests. An overview of, and rationale for, building a PSA protocol, and the advantages and disadvantages of different classes of sedatives and anesthetics, is presented in a clinical context. Finally, injectable drug protocols are reported, supported by an evidence-based approach and clinical experience.

Combination of intramuscular alfaxalone, butorphanol, and midazolam as a novel immobilization protocol in 3 ring-tailed lemurs (Lemur catta)

Background

There is very little data on the optimal anaesthetic management of ring-tailed lemurs, and the available information is mostly based on extrapolation from other species. In addition, a thorough pre-anaesthetic assessment of lemurs might not be possible without prior chemical immobilization, making a safe immobilization protocol essential.

Case presentation

Three ring-tailed lemurs (Lemur catta) were immobilized using a combination of intramuscular alfaxalone (5 mg/kg), butorphanol (0.2 mg/kg), and midazolam (0.2 mg/kg), at the University College Dublin Veterinary Hospital. One lemur was anaesthetised once, two lemurs twice, amounting to five anaesthetic events. Conversion to general anaesthesia was warranted in all five occasions, and anaesthesia was maintained with either sevoflurane in oxygen or alfaxalone infusion. The immobilization protocol provided an adequate duration of deep sedation for diagnostic procedures and in some occasions allowed the intubation of the trachea. Analgesia was also provided for minor procedures. No major complications were noted with the protocol used.

Conclusions

The combination of intramuscular alfaxalone, butorphanol and midazolam provided a clinically useful sedation/immobilization in ring-tailed lemurs with only minor complications such as mild hypothermia, hypotension, hypoventilation and bradycardia. This protocol could be considered in ring-tailed lemurs that need to be immobilized for minor procedures, or as a pre-anaesthetic premedication, especially if a full pre-anaesthetic clinical exam is not possible.

Sedative and physiologic effects of tiletamine–zolazepam following buccal administration in cats

Objectives

The aim of this study was to describe the sedative and some physiological effects of tiletamine–zolazepam following buccal administration (BA) in cats.

Methods

Seven healthy spayed European shorthair cats (three males, four females) were studied twice in this randomized, blinded, crossover study. Each cat received two doses of tiletamine–zolazepam by BA: the low-dose (LD) group consisted of 5 mg/kg of each drug, and the high-dose (HD) group consisted of 7.5 mg/kg of each. Baseline systolic blood pressure (SAP), heart rate (HR), respiratory rate (RR) and a sedation score were recorded prior to administration of each treatment. The same variables plus the percentage of hemoglobin saturated with oxygen as measured by pulse oximetry (SpO2) were recorded at predefined intervals for the next 2 h.

Results

All cats completed the study. No retching or vomiting were observed. Hypersalivation was observed in 0/7 and 3/7 for LD and HD groups, respectively ( P = 0.2). There were significant changes in scores over time for posture, response to clippers and response to manual restraint for both groups, without differences between groups. RR, HR and SAP changed significantly over time. SAP and RR were significantly lower for the HD than for the LD group. No values for hemoglobin saturation <95% were observed.

Conclusions and relevance

BA of tiletamine–zolazepam at the doses studied here is a simple and effective method for chemical restraint in cats, where the LD group had a lower impact on SAP and RR than the HD group.

Live-capture of feral cats using tracking dogs and darting, with comparisons to leg-hold trapping

Context Predation by feral cats is a key threatening process to many species of native Australian wildlife. Unfortunately, cats are difficult to capture using standard trapping techniques, limiting the potential to conduct research on their ecology and impacts. Aims We present an alternative capture method: remote chemical immobilisation after tracking with trained dogs. We also compare capture rates to a concurrent soft-jaw leg-hold trapping program. Methods We used dogs to capture cats detected by spotlighting at night, and also recaptured cats fitted with telemetry collars during the day. Cats were either bailed on the ground or treed and then hand-netted, or chemically immobilised using darts shot from a CO2-powered dart rifle, loaded with tiletamine–zolazepam at ~6 mg kg–1. Factors affecting the success rate of capturing cats using dogs were assessed. Efficiency in terms of cats captured per person-hours of fieldwork were compared using trained dogs versus leg-hold trapping. Key results We attempted 160 cat captures using the tracking dogs with 114 of those being successful. There were no mortalities or debilitating physical injuries associated with chemical immobilisation; however, sedated cats had prolonged recoveries (>4 h). Capture success with the tracking dogs increased as the dogs gained experience. Capture success rates per person-hour of fieldwork were four times greater using spotlighting with tracking dogs than using leg-hold traps. The success rate of recaptures using dogs was 97%. Conclusions The use of trained tracking dogs proved an effective method for capturing feral cats. The method had a much higher success rate than live-trapping with leg-hold traps, took less effort (in terms of person-hours) and caused less physical injuries than did leg-hold traps. However, substantial setup costs and time are required, which are discussed. Implications Using these methods could improve efficiency and outcomes when catching feral cats, and enable more data per individual cat to be collected than otherwise.